[Pneumocystis jiroveci: epidemiological, pathophysiological and biological update]. / Pneumocystis jiroveci : mise à jour épidémiologique, physiopathologique et biologique.

One century after its discovery, Pneumocystis jiroveci is an infectious agent still responsible of a high mortality rate among immunocompromised patients. Molecular biology advances have authorized some important progress mainly concerning epidemiology, pathophysiology and biological diagnosis. It has also brought a lot of publication on the subject. They describe a large panel of different biological diagnosis method. The purpose of this article is to synthesize these knowledges and to update the laboratory diagnosis strategy.

[Malaria: chloroquine resistance]. / Paludisme: la résistance a la chloroquine.

Chloroquine remains the most commonly antimalaric drug utilized all around the world (340 t in 1988). Its efficiency is linked to its action on the digestive vacuole of plasmodium. Since 1957, the areas of resistance are spreading over of an alarming way, striking all continents. 3,000 cases of malaria are imported in France each year, and 90% of the strains tested in vitro by incorporating tritium hypoxanthine are resistant to chloroquine. The resistant parasites are able to exclude chloroquine from their cytoplasm and produce in great number two genes to synthetize a glycoprotein, probable agent of cellular exclusion of the antimalaric drug. Despite of it, to prescribe chloroquine in prophylaxis remains indispensable, because the risk of severe malaria due to some sensitive strains of Plasmodium falciparum.

[Simple methods of chloroquine determination in urine and their adaptation in the field]. / Les méthodes simples de dosage de la chloroquine dans les urines et leur adaptation sur le terrain.

Field malaria studies require often the on site detection of chloroquine in urine for monitoring chemoprophylaxis and treatment compliance, investigating drug-use patterns and screening prospective subjects for in vitro and in vivo chemosensitivity tests. The field adapted methods are described, analytical characteristics are compared and different approaches to field adapted assay of chloroquine are discussed.

Simultaneous determination of chloroquine and quinine in human biological fluids by high-performance liquid chromatography.

A high-performance liquid chromatographic method with fluorescence detection is described for the simultaneous measurement of quinine, chloroquine and mono- and bidesethylchloroquine in human plasma, erythrocytes and urine. After a liquid-solid extraction on a Bond Elut C8 cartridge, the compounds are separated on an Inertsil silica column by gradient elution; the mobile phase is a mixture of acetonitrile and methanol-25% ammonia solution (92.7:7.5, v/v). The eluent was monitored with a fluorescence detector (excitation wavelength 325 nm and emission wavelength 375 nm). The limit of detection was ca. 5 ng/ml for chloroquine and ca. 23 ng/ml for quinine. No chromatographic interferences could be detected from endogenous compounds or other antimalarial drugs. The method is accurate with inter- and intra-assay coefficients of variation lower than 7%. Hydroxychloroquine is used as an internal standard because of its structural similarity to chloroquine. The procedure requires 30 min and can be used for therapeutic drug monitoring.